Robert Fallis

I am trying to interpret the requirements for antigen-antibody testing and compatibility testing of autologous units in the 26th edition (5.12 to 5.15.3) of the AABB Standards. The way the information is organized leads to differing thoughts on how the information is interpreted Questions: 1. Do autologous units require antigen confirmation to a patient's corresponding antibody? 2. Do autologous units require a serological crossmatch when the patient has a clinically significant antibody or a positive antibody screen?

This is an internal benchmark used in our transfusion service business line with full knowledge of the staff's level of experience, motivation, and capabilities; the amount of labour-saving automation employed and the amount of complicated labour-intensive investigative testing performed. In our laboratories, a routine antibody screen includes an ABO/Rh type. If the patient has no historical blood group on file, we perform a second ABO/Rh test on the current sample submitted. We also realize that approximately 5% of the total samples we test require more extensive processing than an antibody screen and/or blood component issued. The count of antibody screens plus blood components issued was simply chosen for ease of counting and calculating the data. The weakness in using this calculation is that the bench mark will not detect a shift in any of the variables mentioned in the first sentence. It is impossible to precisely take into consideration all of these factors and arrive at a “scientifically determined” productivity or staffing target for a transfusion service. I use this bench mark data, along with error rate data and turnaround time data as a reference for making staffing decisions. In spite of these limitations, I believe the data is a useful reference point.

I have been asked for benchmarking data for productivity and as well as for other key areas. From my experience there is very little comparative data available for transfusion or blood bank services. We operate a 24/7 centralized pretransfusion and prenatal testing lab. In the absence of productivity data I have created my own. For a productivity benchmark we determine the number of procedures per FTE. The procedures we count are antibody screens plus blood components issued. We take the total procedures and divide by the number of paid FTE hours. We do this quarterly. We do not include FTE for Medical or Quality Management staff. For example in the first 3 quarters of this year we performed 168,288 procedures consuming 42.5 FTE. This gives us 3958 procedures per FTE. The target we wish to exceed is >3500 procedures per FTE (based on historical data). I also am looking for input on this topic and also any benchmarking data on safety, efficiency and employee engagement.

We have two Galileo and two ECHO instruments in our lab. We have had really good luck with all four with minimal down time. The Galileo instruments do require extensive maintenance but does pay off. I would recommend the Neo which is a new model recently released. It does have STAT sample capablilites were as the old instruments are batch instrument work horses. We run approximately 300 prenatal ABO/ Rh & antibody screens daily, 200 pretransfusion type and screens, 200 ABO confirmations daily. We use the ECHO instruments for STATs and Antibody ID. They reagents and expendables are expensive but have made up for the cost with reduction in technologist labour hours.